摘要
目的:调查分析早期2型糖尿病肾脏病病人饮食结构、实验室指标及人体成分等营养代谢状况。方法:2019年12月到2020年12月在北京医院内分泌科住院,符合中国2型糖尿病防治指南(2020年版)中糖尿病及糖尿病肾脏病的诊断标准,早期糖尿病肾病125例病人纳为研究组(DKD组);同期住院的糖尿病非肾病113例病人(Non-DKD组)纳为对照组;分别进行饮食回顾、人体成分测定、营养代谢相关实验室检查等,分析糖尿病肾脏病病人的代谢特点,以及可能影响肾脏功能(肾小球滤过率)的营养代谢相关因素。结果:DKD组饮食中碳水化合物摄入与Non-DKD组比较差异有显著性意义[278(113)g vs 249(93)g,P=0.006],实验室指标中血肌酐、尿素、尿酸、估算肾小球滤过率、浮肿指数、维生素D水平等指标的差异均有显著性意义(P<0.05)。其中估算肾小球滤过率[94.42(38.70)mL/min/1.73m^(2)vs 104.60(84.24)mL/min/1.73m^(2),P<0.001],浮肿指数[0.39(0.02)vs 0.39(0.01),P=0.028],维生素D[15.20(11.20)ng/mL vs 16.50(9.30)ng/mL,P=0.038]。估算肾小球滤过率与浮肿指数有负相关性(r=-0.474),与白蛋白、维生素D水平等有弱正相关性。结论:2型糖尿病早期肾脏病病人饮食中碳水化合物摄入较多,血浆维生素D水平较低,体成分中浮肿较重;肾脏功能损伤程度与血浆白蛋白和维生素D水平呈正相关。
Objective:Investigation and analysis of diet structure,blood biochemical indexes and body composition of patients with early non-dialysis diabetic kidney disease.Methods:A total of 125 patients who were hospitalized in the Department of Endocrinology of Beijing Hospital from December 2019 to December 2020 and met the diagnostic criteria for diabetes and diabetic kidney disease in the Guidelines for the Prevention and Treatment of TypeⅡdiabetes in China(2020)were included as the study group.113 patients with diabetic non-nephropathy(non-DKD group)were enrolled as the control group.Dietary reviews,body composition measurements,and nutrition metabolismrelated laboratory tests were conducted to analyze the metabolic characteristics of diabetic kidney disease patients and the possible factors related to nutrition metabolism that may affect renal function(glomerular filtration rate).Results:There was significant difference in dietary carbohydrate intake between DKD group and non-DKD group[278(113)g vs249(93)g,P=0.006].The differences in laboratory indicators such as blood creatinine,urea,uric acid,estimated glomerular filtration rate,edema index,vitamin D level and other indicators have significant significance(P<0.05),in which the glomerular filtration rate was[94.42(38.70)mL/min/1.73m~2 vs 104.60(84.24)mL/min/1.73m~2,P<0.001],the edema index was[0.39(0.02)vs 0.39(0.01),P=0.028],the lever of Vitamin D was[15.20(11.20)ng/mL vs 16.50(9.30)ng/mL,P=0.038].There was a negative correlation between glomerular filtration rate and edema index(r=-0.474),and a weak positive correlation with albumin and vitamin D level.Conclusion:Patients with early typeⅡdiabetic nephropathy had more carbohydrate intake in diet,lower plasma vitamin D level and more edema in body composition.The degree of renal function injury was positively correlated with plasma albumin and vitamin D levels.
作者
丁丽丽
刘承宇
程博
陈丽如
王丽娟
崔红元
徐涛
朱明炜
DING Li-li;LIU Cheng-yu;CHENG Bo;CHEN Li-ru;WANG Li-juan;CUI Hong-yuan;XU Tao;ZHU Ming-wei(Department of Nutrition,Beijing Hospital,National Center of Gerontology,Beijing 100730,China;Department of General Surgery,Beijing Hospital,National Center of Gerontology,Beijing 100730,China;Department of Epidemiology and Statistics,Institute of Basic Medical Sciences,School of Basic Medicine,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)
出处
《肠外与肠内营养》
CAS
CSCD
北大核心
2022年第2期75-79,共5页
Parenteral & Enteral Nutrition
基金
中国食品科学技术学会食品科技基金(2020-14)
北京市优秀人才培养资助(2018000032600G394)。
